- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04946084
Dynamic Change and Immune Response to Nasopharyngeal Carriage and Acute Otitis Media Pathogens (AOM)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The investigator's proposed study design involves 2 cohorts. Cohort 1: Collection of middle ear fluid(MEF), NP samples and blood at onset of AOM from otitis prone children and those who have AOM antibiotic treatment failure since these children more frequently harbor antibiotic resistant strains. Children will then be followed prospectively thereafter, collecting NP samples at pre-determined time points when the children are healthy (see cohort 2) and MEF, NP samples and blood if subsequent AOM infections occur. Cohort 2: Healthy children from whom we will prospectively collect NP samplings and blood at any of 7 pre-determined time points (age 6, 9, 12, 15, 18, 24, and/or 30-36 months old as they occur within the study time-frame) to assess commensal carriage of Spn and Hflu. MEF will be obtained from the participants at any AOM occurring, including the first and any subsequent AOM infection. Concurrently detailed demographic, vaccination, epidemiologic and risk factor data known to influence AOM epidemiology will be collected, providing scientific rigor.
Viral respiratory infections will be another focus during this project. The investigators will characterize dynamic changes in patterns of viral co-infections at onset of AOM including the common respiratory viruses RSV A, B, influenza A, B, parainfluenzae virus type 3, rhinovirus, enterovirus, human metapneumovirus, human bocavirus, adenovirus B, C and SARS-CoV-2. The studies will involve viral identification, evaluation of viral/bacterial (otopathogen) interactions and mucosal and systemic immune responses.
The investigators have identified multiple deficiencies in innate and adaptive immunity among young children who are AOM prone and introduced the term "prolonged neonatal-like immune profile (PNIP) because of striking similarities that resemble neonatal immunity. Another focus of this project will be to expand understanding of the central immune deficiencies of APM prone children using blood samples.
A a serum correlate of protection has been defined to predict the effectiveness of pneumococcal conjugate vaccines using blood samples linked to occurrence of NP colonization and AOM events in recent past work. Blood will be used to continue this work.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Michael Pichichero
- Phone Number: 922-5959
- Email: michael.pichichero@rochesterregional.org
Study Locations
-
-
New York
-
Rochester, New York, United States, 14621
- Rochester General Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female subject age 6 to 12 months + 30 days at the time of enrollment when healthy or up to 36 months old + 30 days with an ear infection.
- Subject has received full (3 dose) infant series of PCV.
- Parent/legal guardian must be able and willing to bring subject to all study visits
Exclusion Criteria:
- Any major illness/condition that, in the investigator's judgment, will substantially increase the risk associated with the subject's participation in the study.
- Participation in another investigational or interventional trial within the 28-day period before enrollment and during the conduct of the study. Participation in observational studies is permitted.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Healthy Children
Samples taken from nasal swabs, nasal wash, blood draws and in the case of acute otitis media, tympanocentesis
|
When acute otitis media is diagnosed, local anesthetic applied, small hole placed in eardrum, middle ear fluid extracted.
Other Names:
Nasal phalangeal swab used to retrieve sample.
Nasal wash used to retrieve sample.
Other Names:
Venipuncture
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Characterize which bacterial strains in the NP
Time Frame: 30 months
|
Identify the presence of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catharralis in the nasopharynx of children using in vitro culture
|
30 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Characterize which bacterial strains are AOM causing pathogens
Time Frame: 30 months
|
Identify the presence of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catharralis in the nasopharynx of children using in vitro culture
|
30 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Characterize dynamic changes in patterns of viral co-infections at onset of AOM
Time Frame: 30 months
|
Identify respiratory viruses present in the nasopharynx at onset of acute otitis media in young children using polymerase chain reaction methods.
|
30 months
|
Determine immune responses after NP carriage and AOM infections by the common bacterial respiratory pathogens.
Time Frame: 30 Months
|
Measure serum and nasopharyngeal antibody levels to common bacterial and viral respiratory pathogens with ELISA and immune cellular responses (B cells, T cells, Antigen Presenting cells using flow cytometry and ELISPOT
|
30 Months
|
Determine the serum antibody response that correlates with protection against NP colonization and AOM.
Time Frame: 30 months
|
Establish a correlate of protection for pneumococcal serotypes that colonize the nasopharynx and cause acute otitis media in young children using ELISA
|
30 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Michael Pichichero, MD, Rochester General Hospital Research Institute
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB 2031 A
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Acute Otitis Media
-
AcclarentCompletedRecurrent Acute Otitis Media | Acute Otitis Media | Chronic Otitis MediaUnited States
-
David Chi, MDRecruitingRecurrent Acute Otitis Media | Chronic Otitis Media With Effusion | Otitis Media in ChildrenUnited States
-
Medical College of WisconsinNational Institutes of Health (NIH); National Institute on Deafness and Other... and other collaboratorsRecruitingOtitis Media | Otitis Media With Effusion | Otitis Media AcuteUnited States
-
Tusker MedicalCompletedAOM - Acute Otitis Media | OME - Otitis Media With EffusionUnited States, Canada
-
Smith & Nephew, Inc.RecruitingOtitis Media | Otitis Media With Effusion | Acute Otitis MediaUnited States
-
AcclarentCompletedOtitis Media With Effusion | Acute Otitis MediaUnited States
-
University of OuluOulu University HospitalCompletedAcute Otitis MediaFinland
-
University of WashingtonStandard Homeopathic CompanyCompleted
-
PfizerCompletedAcute Otitis MediaCosta Rica
-
University of TurkuFinnish Institute for Health and WelfareUnknown